<?php echo form_open('payroll/editPayroll',array('class'=>'form-horizontal','id'=>'frm'));?>
<fieldset>
    <legend><h4><?php echo $title;?></h4></legend>
    <div class="control-group">
        <label class="control-label">Staff</label>
        <div class="controls">
          <?php echo form_dropdown('StaffID',$staffs, $payroll['staffID']) ?>
        </div>
  </div>
  <div class="control-group">
        <label class="control-label">Payroll Date</label>
        <div class="controls">
          <input type="text" name="PayRollDate" value="<?php echo $payroll['PayRollDate']; ?>" class="validate[required] datepicker" />
        </div>
  </div>
  <div class="control-group">
        <label class="control-label">Gross Salary</label>
        <div class="controls">
          <input type="text" name="grossSalary" placeholder="Gross Salary" value="<?php echo $payroll['grossSalary']; ?>" class="validate[required]" />
        </div>
  </div>
  <div class="control-group">
        <label class="control-label">Salary Tax</label>
        <div class="controls">
          <input type="text" name="SalaryTax" value="<?php echo $payroll['SalaryTax']; ?>" placeholder="Salary Tax" class="validate[required]" />
        </div>
  </div>
  <div class="control-group">
        <label class="control-label">Other</label>
        <div class="controls">
          <input type="text" name="Other" value="<?php echo $payroll['Other']; ?>" placeholder="Other" />
        </div>
  </div>
  <div class="control-group">
        <label class="control-label">Salary Advance</label>
        <div class="controls">
          <input type="text" name="SalaryAdvance" value="<?php echo $payroll['SalaryAdvance']; ?>" placeholder="Salary Advance" />
        </div>
  </div>
  <div class="control-group">
        <label class="control-label">Health Benifit</label>
        <div class="controls">
          <input type="text" name="HealthBenifit" value="<?php echo $payroll['HealthBenifit']; ?>" placeholder="Health Benifit" />
        </div>
  </div>
  <div class="control-group">
        <label class="control-label">PhoneAllowance</label>
        <div class="controls">
          <input type="text" name="PhoneAllowance" value="<?php echo $payroll['PhoneAllowance']; ?>" placeholder="Phone Allowance" />
        </div>
  </div>
  <div class="control-group">
        <label class="control-label">Bank Charge</label>
        <div class="controls">
          <input type="text" name="BankCharge" value="<?php echo $payroll['BankCharge']; ?>" placeholder="Bank Charge" />
        </div>
  </div>
  <div class="control-group">
        <label class="control-label">Annual Leave</label>
        <div class="controls">
          <input type="text" name="AnnualLeave" value="<?php echo $payroll['AnnualLeave']; ?>" placeholder="Annual Leave" />
        </div>
  </div>
  <div class="control-group">
        <label class="control-label">Annual Bonus</label>
        <div class="controls">
          <input type="text" name="AnnualBonus" value="<?php echo $payroll['AnnualBonus']; ?>" placeholder="Annual Bonus" />
        </div>
  </div>
  <div class="control-group">
        <label class="control-label">Over Time</label>
        <div class="controls">
          <input type="text" name="OverTime" value="<?php echo $payroll['OverTime']; ?>" placeholder="Over Time" />
        </div>
  </div>
  <div class="control-group">
    <label class="control-label">Notes</label>
    <div class="controls">
       <textarea name="Notes" placeholder="Notes" rows="3"><?php echo $payroll['Notes']; ?></textarea>
    </div>
  </div>
  <?php 
    echo form_hidden('payRollID',$payroll['payRollID']);
    echo $form; 
  ?>
 </fieldset> 

<?php echo form_close();?>